Breaker Rock Beach Kids Camp registration form
July 9,10 & 11; 6:15-8:30 pm

At Breaker Rock Beach, children will embark on a journey of exploration and discovery, learning that while life may change, God’s truth remains constant. The camp will feature engaging activities including Tide pool crafts, Sea Lion snacks, Orca Worship, and Ship Rec, all designed to reinforce key faith concepts in a fun and interactive way.

Register your children, ages 4 yrs. to completed 5th grade

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Email *
Parent's name *
Address *
City *
Zip Code *
Phone number *
Name of emergency contact *
Emergency contact phone number *
Child's name *
Child's Birthday *
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Age/grade completed   *
Allergies
Child's name
Child's Birthday
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Allergies
Child's name
Child's Birthday
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Allergies
Child's name
Child's Birthday
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DD
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Age/ Grade completed
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Child's name
Child's Birthday
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DD
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Allergies
Any additional children please add their name, DOB, Age/Grade completed, Allergies, here.
A copy of your responses will be emailed to the address you provided.
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